IM's comprehensive goals and objectives under the award, reflecting breadth across technical areas

The goal of this mechanism is to provide technical assistance across various program areas to support PEPFAR programming. The mechanism will support six program advisor/fellows that will provide technical assistance and analysis to in-country PEPFAR team on several activities. The goal of the fellowship is to enhance the training of future public health professionals who are interested in addressing public health issues globally. The support offered through this program fosters the USG field public health workforce by allowing fellows to apply theoretical knowledge to real world public health situations and gain practical, first-hand experience on the front lines while mentoring/cross-training and building skills of local public health staff.

Program activity will focus on strengthening various evaluations and assist with analysis across programs to ensure implementation and completion of studies, assessments and program evaluations have been planned and initiated in late 2009. Part of activity will be to support and improve scientific skills of USG LES staff by developing and conducting short training activities on research protocol development, research administration, scientific writing, data use, analysis etc. They will work to support USG team to perform literature reviews on subjects relevant to program evaluations to support roll-out of Partnership Framework goals and objectives and host country priorities. Fellows supported under this mechanism will perform secondary analysis of program data and ensure broad distribution of findings when necessary.

CDC Tanzania Fellows are mentored by Senior Leadership in all five programs (Lab, Clinical, PHE, Strategic Information and Prevention) and are partnered with local public health professionals to share and expand knowledge. They add fresh ideas and participate in specific projects based on their area of expertise and the needs of PEPFAR Interagency Teams.

Contributions to Health Systems Strengthening (if relevant)

CDC Tanzania Fellows are mentored by Senior Leadership in all five programs (Lab, Clinical, PHE, Strategic Information and Prevention) and are partnered with local public health professionals to share and expand knowledge. They add fresh ideas and participate in specific projects based on their area of expertise and the needs of PEPFAR Interagency Teams. While the aim of the fellowship to expand foundation of public health professionals, it has a spill over effect by providing a twinning platform of sharing knowledge and experience between US public health professionals and host country professionals.

Cross-cutting programs and key issues: describe

Each fellow is assigned to a specific program area within CDC Tanzania. Two fellows directly support all activities under the Strategic Results Units for Clinical Services and for Health Systems Strengthening. Fellows will be asked to present brown bags on their activities/projects to the rest of the agencies' staffs, providing another channel of information sharing and technical crossover.

IM strategy to become more cost-efficient over time (e.g. coordinated service delivery, PPP, lower marginal costs, etc.)

Previously, CDC utilized this mechanism to support one or two fellows a year but recognized that by having individuals dedicated to analyzing key public health challenges and writing up these findings, helped assist the in-country team to effectively and strategically think through program needs and plan appropriately for future. The ASPH Fellowship is only for one year, with an option to renew for a second year. The cost is marginal compared to other mechanisms to bring in this skill level and talent to the PEPFAR Team. CDC Tanzania does not see this program growing beyond the current number of fellows and will likely be decreasing over the next two years.

Geographic coverage & target populations

The fellows do not have any specific coverage or target populations.

M&E plans

Fellows and mentors enter into a mentorship agreement for the year, which is reevaluated every 6 months. Fellows' work performance is evaluated and reviewed twice a year by their in-country mentors, LES counterparts and ASPH headquarter staff.

This activity supports 25% of one ASPH fellow. This includes Stipend, Health, Internal travel, Housing, Local travel, Shipping and Administration costs. In an effort to evaluate and improve prevention programs and interventions implemented in Tanzania, a number of prevention and prevention-related Public Health Evaluations (PHEs), studies, assessments and program evaluations have been planned and initiated in late 2008 or early 2009.

ASPH is assisting with coordination, facilitation, implementation and coordination of various prevention study, program evaluation and research activities that include the following activities listed below. He is also assisting with capacity building for Tanzania prevention program staff in areas of prevention research and M&E.

- Assessment of STI prevalence, diagnosis and treatment in HIV infected persons: This is a study of sexually transmitted infections (STIs) in one site in Pwani region (linking with Positive Prevention and Combination Prevention efforts and evaluations). Objectives of this pilot include assessing the prevalence of STIs in the care and treatment population, determining the validity of syndromic STI diagnosis for HIV-infected patients, and identifying both behavioral and clinical cofactors for prevalent genital infections.

- "Combination Prevention": Basic program evaluation at specific geographic sites (one model in Kagera, one in Pwani) for implementation of a 'saturation' model, i.e. intensified prevention interventions and services with evaluation of outcomes, possibly impact through incidence testing of prevention intervention packages (e.g. CT, PP, STI, MC, etc.).

- Support for follow-up on three evaluations currently ongoing in the area of Infection prevention & Control: Health Care Worker safety, alternative and innovative waste management methods, and prescription record review in conjunction with reduction of unnecessary injections.

- Technical assistance to USAID and its partner T-MARC for a condom distribution study.

- Assistance with training of staff and write-up and submission of research determinations for relevant prevention program activities.

This activity supports 100% of one ASPH fellow. This includes Stipend, Health, Internal travel, Housing, Local travel, Shipping and Administration costs. This activity will support one fellow will provide analysis to improve clinical services:

Collects and interprets data and information from a variety of sources and prepares recommendations accordingly to USG team.

Recommends and incorporates quality management and quality improvement methods into systems strengthening strategies.

Conducts detailed analyses of costs and results of program strategies aimed at stregthening national response.

Integrates financial data with strategic results to assist in program planning and decision making functions of the Strategic Results Unit (SRU).

Analyzes program data to define problems, identify potential solutions, and solicit support for program strategies.

Researches various sources and references and responds to inquiries, prepares issue and background papers, reports and other substantive program documents (e.g., Office of the Global AIDS Coordinator OGAC).

Provides program support for budget development and analysis, program planning, document preparation and statements of work.

Performs literature reviews on best practices in systems strengthening and conducts assessments of current strategies to identify strengths and gaps.

Assists with coordination of data related to reprogramming of funds and other administrative issues

This activity supports 100% of one fellow, 50% of second, 20% of third, and 20% of the fouth fellow. This includes Stipend, Health, Internal travel, Housing, Local travel, Shipping and Administration costs. This activity works to provide support to the surveillance team on the laboratory based aspects of surveillance creating close working relationships and linkages between the surveillance team, the laboratory team and MOHSW. Ensures coordination of input from stakeholders

Technical assistance and support for Respondent Driven Sampling for MARPS study with NACP.{rovide support to the USG team and Government of Tanzania in four primary areas including: 1) serving as a focal person for surveillance and M&E issues on a selected USG interagency team, 2) be responsible for technical guidance and finalization of select special studies in sero and behavioral surveillance, 3) assist the CDC-Tanzania Epidemiology/Surveillance team and the National AIDS Control Program in coordination of high priority studies, 4) fulfill other duties as assigned for the Strategic Information teams such as logistics, report development, and field monitoring.

Assistance with APR and COP requirements, Data Quality and Build capacity of staff for basic program evaluations.

Provides for program analysis and issue research. Project coordination to facilitate SI efforts across program.

This is 30% of one ASPH fellow. This includes Stipend, Health, Internal travel, Housing, Local travel, Shipping and Administration costs. Provides for program analysis and issue research

This activity supports 25% of one ASPH fellow. This includes Stipend, Health, Internal travel, Housing, Local travel, Shipping and Administration costs. In an effort to evaluate and improve prevention programs and interventions implemented in Tanzania, a number of prevention and prevention-related Public Health Evaluations (PHEs), studies, assessments and program evaluations have been planned and initiated in late 2008 or early 2009. ASPH is assisting with coordination, facilitation, implementation and coordination of various prevention study, program evaluation and research activities that include the following activities listed below. He is also assisting with capacity building for Tanzania prevention program staff in areas of prevention research and M&E. - Assessment of STI prevalence, diagnosis and treatment in HIV infected persons: This is a study of sexually transmitted infections (STIs) in one site in Pwani region (linking with Positive Prevention and Combination Prevention efforts and evaluations). Objectives of this pilot include assessing the prevalence of STIs in the care and treatment population, determining the validity of syndromic STI diagnosis for HIV-infected patients, and identifying both behavioral and clinical cofactors for prevalent genital infections.

- "Combination Prevention": Basic program evaluation at specific geographic sites (one model in Kagera, one in Pwani) for implementation of a 'saturation' model, i.e. intensified prevention interventions and services with evaluation of outcomes, possibly impact through incidence testing of prevention intervention packages (e.g. CT, PP, STI, MC, etc.).

- Support for follow-up on three evaluations currently ongoing in the area of Infection prevention & Control: Health Care Worker safety, alternative and innovative waste management methods, and prescription record review in conjunction with reduction of unnecessary injections.

- Technical assistance to USAID and its partner T-MARC for a condom distribution study.

- Assistance with training of staff and write-up and submission of research determinations for relevant prevention program activities.

Program activity will focus on stregthening various PHEs across program to ensure implementation and completion for USG team (HOPE STUDY). Given the sheer number of Public Health Evaluations (PHEs), studies, assessments and program evaluations have been planned and initiated in late 2009, this activity supported by one program advisor/fellow will ensure careful attention to detail. They will develop and promote basic program and public health evaluations by CDC staff and takes lead in country on at least one major current research activity such as sexually transmitted infection prevalence in HIV infected populations, cost effectiveness of different methods of condom distribution, and pediatric antiretroviral outcome evaluation. Improve scientific skills of USG LES staff by developing and conducting short training activities on research protocol development, research administration, scientific writing, data use etc. Performs literature reviews on subjects relevant to program evaluations and public health evaluation. Performs secondary analysis of program data and writes and supports others to write reports, publications and policy briefings. Develops and supports process for PEPFAR Tz abstract, protocol and publication reviews Improves awareness of human subjects issues amongst USG/HHS staff and partners through training and mentoring. Develops and maintains systems for tracking of human subjects issues, protocols, publications, other research materials. This activity supports 100% of one ASPH fellow. This includes Stipend, Health, Internal travel, Housing, Local travel, Shipping and Administration costs.

This activity supports 80% of one ASPH fellow and 50% of a second fellow. This includes Stipend, Health, Internal travel, Housing, Local travel, Shipping and Administration costs. This activity creates linkages between the laboratory infrastructure program and PHE unit and assists the lab and PHE to obtain relevant input from other sections who are laboratory stakeholders into the PHE ensuring coordination of input and assessment of needs.

This activity supports laboratory program on abstract formulation, program planning and monitoring of program implementation

Attends meetings in country stakeholders relevant to laboratory aspects of all program areas to develop own public health capacity and assist with program advocacy to other programs areas;

In country site visits with program personnel from laboratory infrastructure and other sections to provide perspective on program implementation on site; and

Lab strategic planning and provision of technical assistance for central procurement planning of lab supplies and equipment.